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Published on: July 24, 2013
Could Frailty be an Explanatory Factor of the Association between Depression and Other Geriatric Syndromes in Later
Marcus Kiiti Borges1, Richard C Oude Voshaar2, Carla Fernanda de Vasconcellos Romanini3
1Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo , São Paulo, Brazil.
Objectives:
This study aimed to investigate whether frailty could be an explanatory factor of the association between depression and the number of geriatric syndromes.
Methods:
Cross-sectional baseline data from a cohort study (MiMiCS-FRAIL) were analyzed in a sample of 315 older adults. Depression was measured according to DSM-5 criteria and a self-report questionnaire (PHQ-9). Frailty was assessed according to the FRAIL questionnaire and a 30-item Frailty Index (FI). We considered six geriatric syndromes. Multiple linear regression analyses were performed and adjusted for potential confounders.
Results:
Multiple linear regression analyses yielded significant associations between depression and geriatric syndromes. These associations decreased substantially in strength when frailty was added to the models. Findings were consistent for different definitions of depression and frailty.
Conclusions:
Among depressed patients, frailty may be hypothesized as a causal pathway toward adverse health outcomes associated with depression. Longitudinal studies should explore the causality of this association.
Clinical Implications:
Frailty should be treated or prevented in order to minimize the impact of other geriatric syndromes among depressed older adults. Screening for frailty would be of utmost importance in mental health care, as frailty is neglected especially in this field. Integrated care models are crucial for clinical practice in mental illness care.
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